The optimal therapeutic strategy for patients with T2-3N0-3 M0 or T1N1-3 M0 hypopharyngeal squamous cell carcinoma (HPSCC) and the use of postoperative radiotherapy with or without systemic therapy for patients with T1-2N1M0 HPSCC remain controversial. We aimed to determine whether these additional treatments improve the prognosis in HPSCC.

We retrospectively analyzed the databases held by the SEER (surveillance, epidemiology, and end results) program and a tertiary referral center in China to evaluate the survival outcomes of surgical intervention for T2-3N0-3 M0 and T1N1-3 M0 HPSCC and of postoperative radiotherapy for T1-2N1M0 disease.

The SEER contained data for 1235 patients with T2-3N0-3 M0 or T1N1-3 M0 HPSCC, of whom 220 underwent surgery as their first treatment and 737 received non-surgical treatment. There was no statistically significant difference in overall survival (OS) between these two groups. Data were also available for 30 patients in the SEER who were treated by surgery alone (n = 11), surgery plus postoperative radiotherapy (n = 7), or surgery plus postoperative radiotherapy with systemic therapy (n = 12). Similarly, 23 patients at our hospital were identified to have been treated by surgery alone (n = 7), surgery plus postoperative radiotherapy (n = 10), or surgery plus postoperative radiotherapy with systemic therapy (n = 6). The SEER data indicated that postoperative radiotherapy improved OS (hazard ratio 0.281, 95% confidence interval 0.079-0.998; p = 0.036). This finding was supported by the data from our hospital, although the improvement in OS was not statistically significant (hazard ratio 0.360, 95% confidence interval 0.057-2.261; p = 0.224). Postoperative radiotherapy with systemic therapy seemed not to improve OS beyond that achieved by postoperative radiotherapy alone.

There was no significant difference in OS in patients with T2-3N0-3 M0 or T1N1-3 M0 HPSCC according to whether or not they underwent surgery as first-line treatment. Surgery plus postoperative radiotherapy was associated with a more favorable prognosis than surgery alone in patients with T1-2N1M0 HPSCC.

We aimed to, for the first time, assess the value of modified textbook outcome (mTO) in robot-assisted middle pancreatectomy (RMP) procedures.

Pancreatic fistula remains to be the major complication after RMP. Textbook outcome (TO) is introduced to capture the most desirable surgical outcomes. The value of TO in RMP surgery remains unknown.

All patients who underwent RMP in our center from 2010 to 2023 were enrolled in the study. Baseline characteristics, operative outcomes, and oncological outcomes were collected and analyzed. Textbook outcome was calculated separately for each patient and analyzed.

The mTO was defined by the absence of modified post-operative pancreatic fistula (mPOPF), postpancreatectomy hemorrhage (PPH), severe complications (Clavien-Dindo ≥ III), readmission, and in-hospital mortality (IHM). The overall mTO rate and mPOPF rate of 209 patients were 73.68% and 15.79%, respectively. Patients who achieved modified textbook outcomes have shorter post-operative hospitalization days (median (IQR), 17 (9) vs. 34 (26), p < 0.001). Passing the learning curve leads to a reduction of the mPOPF rate and an increase of the mTO rate.

Modified textbook outcome is a practical metric for evaluating ideal surgical outcomes in RMP surgery. Follow-up multi-center clinical research is necessary to evaluate this indicator even further.

The present investigation was designed to assess the prognostic value of microRNA-648 (miR-648) in osteosarcoma (OS) and elucidate its regulatory mechanisms. Quantitative real-time PCR was employed to measure miR-648 expression levels in 80 paired OS specimens and their matched adjacent non-tumor tissues. Statistical assessments of clinical parameters were conducted using Chi-squared tests, while patient survival data were evaluated through Kaplan-Meier estimation and Cox proportional hazards regression modeling. Functional assays were performed in OS cell lines. Bioinformatic prediction of target genes was followed by experimental validation using dual-luciferase reporter assays. MiR-648 exhibited significant downregulation in OS clinical specimens and cell lines (p < 0.001). Low miR-648 expression correlated with lung metastasis (p = 0.027), advanced Enneking stage (p = 0.031), and poorer progression-free survival (p < 0.001). MiR-648 was identified as a significant independent prognostic indicator (hazard ratio [HR] = 0.235, p < 0.001). Moreover, the overexpression of miR-648 significantly suppressed cellular proliferation, migration capacity, and invasion potential while enhancing apoptotic activity (p < 0.001). High mobility group box 1 (HMGB1) was confirmed as a direct target, with its role in reversing miR-648's tumor-suppressive effects. MiR-648 exerts tumor-suppressive effects in OS by modulating HMGB1, suggesting its clinical utility as both a prognostic biomarker and a therapeutic intervention point.

Female urethral adenocarcinoma (FUA) is an exceptionally rare and aggressive malignancy, accounting for less than 0.02% of all cancers in women. Its nonspecific symptoms often lead to delayed diagnosis, with many cases detected at advanced stages. The rarity of FUA, particularly when presenting with a large mass, underscores the challenges in developing standardized treatment protocols.

A 65-year-old woman presented with urinary retention. Clinical examination revealed a large mass obstructing the urethral orifice. A computed tomography (CT) scan showed a malignant mass involving the entire length of urethra, with no signs of metastasis. Percutaneous cystostomy was performed, and cystoscopy through the cystostomy access revealed tumor infiltration into the anterior bladder wall, approximately 2 cm from the bladder neck. A radical urethrectomy with partial cystectomy and bladder outlet reconstruction was performed via a transurethral approach, with antegrade cystoscopy guidance. The bladder outlet was reconstructed using a segment of the anterior bladder wall to facilitate voiding through the orthotopic site with a Foley catheter. Pathology confirmed pT4 urethral adenocarcinoma with enteric subtype and clear surgical margins. Neither radiation nor chemotherapy was administered. At the 1-year follow-up, the patient was in continuous incontinence status. This condition is expected since the sphincter was also resected during the surgery as the tumor already infiltrated the anterior bladder. But with the use of silicone catheter, we can avoid any leak and patient still can void timely through regularly clamp catheter. At the 1-year follow-up, the patient reported satisfaction with her quality of life and showed no signs of recurrence or metastasis.

This case highlights the feasibility of bladder-preserving surgical techniques in giant FUA with bladder infiltration. The approach achieved oncological control while maintaining the patient's quality of life. Bladder outlet reconstruction provided satisfactory functional outcomes and eliminated the need for suprapubic urinary diversion.

We aimed to identify clinicopathological risk factors associated with distant metastasis in follicular thyroid cancer (FTC) and to evaluate prognostic factors influencing survival in distant metastatic FTC patients, thereby providing evidence for risk stratification and personalized treatment strategies.

In this retrospective study, we enrolled FTC patients who underwent total thyroidectomy, subtotal thyroidectomy, or thyroid lobectomy at the Affiliated Hospital of Qingdao University from January 2014 to December 2021. Eligible patients were divided into 2 groups: the distant metastasis group (DM group) and the group with no evidence of distant metastasis during the study period (NDM group). The DM group was further divided into the survival group and the mortality group at the last follow-up.

In total, 111 patients who underwent thyroid surgery were included. 30 patients (27.03%) had distant metastasis (DM group), and 81 patients (72.97%) had no distant metastasis (NDM group). Multivariate logistic regression analysis indicated that the FTC subtype (odds ratio [OR]: 141.244; 95% confidence interval [CI]: 7.128-2798.802; P = 0.001), the number of lymph node metastases LNMs (OR: 0.028; 95% CI: 0.001-0.563; P = 0.020), T stage (OR: 0.048; 95% CI: 0.003-0.766; P = 0.032) and the type of initial surgery (OR: 175.685; 95% CI: 6.452-4783.472; P = 0.002) were independent risk factors predicting DM. Overall, the 3-year cumulative survival rates of DM patients was 83.0%. Kaplan-Meier survival analysis revealed significant differences in the 3-year survival time according to T stage (P = 0.019).

Widely invasive FTC, lymph node metastasis, T3/T4 stage, and initial total thyroidectomy are independent predictors of distant metastasis in FTC patients. For FTC patients with DM, high T stage may be related to a greater likelihood of mortality.

Cancer treatment relies heavily on accurate diagnosis and effective monitoring of the disease. These processes often involve invasive procedures, such as colonoscopy, to detect malignant tissues, followed by molecular analyses to determine relevant biomarkers. This study aimed to evaluate the clinical performance of droplet digital PCR (ddPCR) for detecting Kirsten Rat Sarcoma Viral Proto-Oncogene (KRAS), Neuroblastoma RAS Viral Oncogene Homolog (NRAS), and B-Raf Murine Sarcoma Viral Oncogene Homolog B (BRAF) mutations in circulating tumor DNA (ctDNA) from colorectal cancer patients using liquid biopsy.

ctDNA was isolated from colorectal cancer (CRC) patients (n = 110) and analyzed for KRAS, BRAF, and NRAS mutations. The ctDNA obtained through liquid biopsy was analyzed using ddPCR, and the findings were compared with sequencing data from tumor DNA archived in formalin-fixed paraffin-embedded (FFPE) blocks.

For KRAS mutations, ddPCR achieved a sensitivity of 72.0% and a specificity of 71.4%. However, when pooling all target mutations (KRAS, NRAS and BRAF), the overall sensitivity and specificity were lower, at 48.3% and 51.1%, respectively.

The results of this study indicate that the ddPCR analysis of ctDNA may provide complementary information for the molecular diagnosis of CRC patients.

To determine whether immunotherapy can bring new hope for patients with limited-stage small-cell lung cancer (LS-SCLC). We conducted this retrospective study to evaluate whether immunotherapy can achieve better efficacy in LS-SCLC patients.

We evaluated 122 LS-SCLC patients who received concurrent chemoradiotherapy (CCRT) or sequential chemoradiotherapy (SCRT) (Group A) and immunotherapy combined with CCRT/SCRT followed by immunotherapy (Group B), to assess the objective response rate (ORR), disease control rate (DCR), and progression-free survival (PFS). Factors affecting prognosis were also explored using Cox analysis. The prognosis of patients with type 2 diabetes and patients with different TNM stages was compared to guide the selection of clinical regimens.

The overall ORR was 55.93%. The overall DCR was 98.31%. The DCR was 100% in Group A and 96.61% in Group B. There was no statistical difference in ORR and DCR. The overall median PFS was 9.86 months (95% CI, 8.62-11.10), and the difference in median PFS between the two groups was statistically significant (8.94 vs. 11.89 months, p = 0.03). The Cox regression analysis showed type 2 diabetes was associated with the survival prognosis. Patients with type 2 diabetes tended to choose immunotherapy combined with CCRT/SCRT. Patients in TNM stage IIIB had a significantly worse prognosis than those in stage I + II + IIIA.

We suggest that LS-SCLC patients who receive immunotherapy combined with CCRT/SCRT can achieve longer PFS than those with CCRT/SCRT. Type 2 diabetes and TNM stage affect the survival prognosis. Patients with type 2 diabetes may benefit from immunotherapy combination treatments.

Colorectal cancer (CRC) is the third most common malignancy worldwide and the second leading cause of cancer-related deaths, accounting for approximately 10% of all cancer cases. By 2050, CRC incidence is expected to rise substantially, driven by population aging and greater exposure to risk factors in developing countries. Despite advances in medicine and pharmacy, the effectiveness of available treatments remains limited, underscoring the urgent need for innovative therapeutic strategies. This review summarizes and critically evaluates currently available CRC therapies and explores new emerging directions. Particular attention is given to the role of immunotherapy, targeted therapies, nanotechnology-based approaches, metal-based compounds, PROTAC technology, and personalized medicine, with emphasis on their efficacy, safety, accessibility, and mechanisms of drug resistance. In conclusion, surgery and chemotherapy remain the backbone of CRC treatment, but novel therapeutic approaches are reshaping the treatment landscape. Emerging strategies may offer improved patient tolerability and survival outcomes by reducing the occurrence of burdensome adverse effects. Persistent challenges such as drug toxicity, the emergence of resistance mechanisms, and inequalities in access to innovative therapies underscore the need for further translational research. Integrating personalized therapeutic approaches will also be crucial to achieving more effective, safer, and accessible treatment strategies for CRC.

Early detection of hepatocellular carcinoma (HCC) is a significant challenge due to the limited sensitivity of alpha-fetoprotein (AFP). This study aimed to assess serum-derived extracellular vesicle-encapsulated GULP PTB domain-containing engulfment adaptor 1 (EV-GULP1) as a novel, noninvasive biomarker for HCC detection and prognosis, leveraging the potential of tumor-specific molecules carried by small extracellular vesicles (EVs).

The study utilized both internal and external cohorts of HCC patients and controls. Small EVs were isolated from serum samples, then characterized and validated to confirm their identity. The expression levels of EV-GULP1 were quantified using quantitative reverse transcription polymerase chain reaction (qRT-PCR).

EV-GULP1 expression was found to be significantly higher in HCC patients, including those with early-stage disease, when compared to control groups. It demonstrated superior diagnostic accuracy over AFP, achieving an area under the curve (AUC) of 0.919, and was particularly effective in detecting AFP-negative cases. Furthermore, high EV-GULP1 expression correlated with worse overall and disease-free survival outcomes.

These findings highlight EV-GULP1 as a highly promising noninvasive biomarker for hepatocellular carcinoma. It offers improved diagnostic accuracy for early detection and better risk stratification for prognosis compared to the current standard, AFP.

Although immune checkpoint inhibitors (ICIs) and targeted therapies have reshaped treatment non-small cell lung cancer (NSCLC) paradigms, prognosis remains poor for many patients due to delayed diagnosis and resistance mechanisms. Liquid biopsy offers a minimally invasive approach to monitoring tumor evolution. Among circulating biomarkers, circulating tumor cells (CTCs) and cancer-associated macrophage-like cells (CAM-Ls) may provide complementary prognostic insights. The study aimed to evaluate the prognostic role of CTC and CAM-Ls dynamic in metastatic NSCLC patients.

We retrospectively analyzed 77 patients with metastatic NSCLC who underwent CTC and CAM-L evaluation via the CellSearch® system at baseline (T0) and after three months of first-line treatment (T1) including chemotherapy, targeted therapy, or ICIs. Survival outcomes were analyzed using Kaplan-Meier and Cox regression analyses.

Conversion to CTC-negative status at T1 was associated with improved outcomes, with median overall survival (OS) and progression-free survival (PFS) of 33 and 18 months, respectively, vs. 10 and 6 months in persistently positive patients (both p < 0.001). CTC negativity at T1 remained an independent prognostic factor for OS (HR: 6.68) and PFS (HR: 5.91, both p < 0.0001). CAM-L positivity at T1 also correlated with longer OS (30 vs. 12 months) and PFS (13 vs. 6 months, both p < 0.0001), particularly among ICI-treated patients. Combined CTC and CAM-L assessment further refined risk stratification.

Dynamic monitoring of CTCs and CAM-Ls provides actionable prognostic information in metastatic NSCLC. CTC-negative status predicted longer OS and PFS, while CAM-L positivity at T1 was associated with improved outcomes, particularly in ICI-treated patients. Combined assessment of both biomarkers may directly inform therapeutic decision-making, through early detection of outcomes.